Tool For Continuous Improvement Research Articles

The benchmarking implementation and management control process as influenced by interplay of environmental and cultural factors: institutional and contingency perspectives

PurposeThe purpose of this paper is to investigate the influence of environmental and cultural factors on the benchmarking implementation process and management control within organizations in the United Arab Emirates (UAE). By exploring the complex interplay of these factors, the study aims to uncover how environmental considerations and cultural dynamics shape the effectiveness and outcomes of benchmarking initiatives in the UAE's unique business environment. The research seeks to provide valuable insights for organizations in the UAE to optimize their benchmarking practices and enhance their overall performance and competitiveness.Design/methodology/approachThe study adopts a mixed-methods approach, combining qualitative and quantitative methods to comprehensively explore the influence of environmental and cultural factors on benchmarking implementation and management control in the UAE. This study draws on the integration of two main theoretical perspectives: institutional theory and contingency theory. This is the first attempt to integrate these different frameworks in a single study. The study presents a case study of Emirates Industrial City (EIC), which has been recognized by global industries for boosting efficiency, cost control, quality and overall operations. The quality method known as benchmarking maximizes the potential for organizations to achieve optimal levels of production efficiency.FindingsThis paper provides compelling evidence that the benchmarking implementation process and management control in the UAE are significantly influenced by the complex interplay of environmental and cultural factors. By recognizing the importance of environmental sustainability and cultural values in guiding benchmarking practices, UAE organizations can optimize their performance and competitiveness. The findings contribute valuable insights to the existing literature, offering practical implications for UAE organizations seeking to leverage benchmarking as a strategic tool for growth and continuous improvement. The findings reveal that UAE organizations incorporating environmental considerations into benchmarking practices demonstrate a proactive approach to sustainability, aligning their goals with eco-friendly practices. Cultural influences, including a culture of collaboration and openness to external learning, contribute to successful benchmarking adoption and knowledge sharing. Moreover, the study highlights that the integration of benchmarking outcomes into the management control process positively correlates with organizational performance. UAE organizations that leverage benchmarking data for decision-making and performance evaluation exhibit higher levels of competitiveness and efficiency.Research limitations/implicationsThis paper has important implications for organizations in the UAE seeking to optimize their benchmarking practices and management control. The study's findings can guide organizations in aligning their benchmarking efforts with environmental sustainability goals and cultural values to enhance performance and competitiveness. Understanding the influence of environmental and cultural factors on benchmarking adoption and implementation allows organizations to foster a benchmarking culture that embraces knowledge sharing and learning. Managers can tailor their approaches to accommodate cultural nuances and enhance the effectiveness of benchmarking initiatives.Originality/valueThis paper contributes to the existing body of knowledge in several ways. Integrated approach: By examining the complex interplay of environmental and cultural factors, this study takes an integrated approach of institutional and contingency theories to understanding their influence on benchmarking implementation and management control. It offers a comprehensive view of how these factors interact to shape organizational practices and outcomes. UAE context: The study focuses specifically on the UAE, providing insights into benchmarking practices within the unique environmental and cultural context of the nation. This research addresses a gap in the literature by examining the influence of these factors in a distinct business environment.

Program Report: Improving Patient Experience at an Outpatient Clinic Using Continuous Improvement Tools.

Patient satisfaction with prompt and high-quality healthcare services plays a pivotal role in healthcare settings. The delivery of high-quality services within the healthcare sector is closely associated with continuous quality improvement (CQI), which is an incremental and progressive process that prioritizes the safety of all participants, favorable outcomes, systematic processes, and a regulated and improved working environment, particularly in later stages. Surprisingly, these aspects are less frequently explored in Middle Eastern countries. Thus, this research paper aims to assess the impact of quality services on patient satisfaction in tertiary care clinics located in the Middle East. To improve the quality of services in our clinic, we employed patient feedback as a valuable resource. We proactively reached out to all patients who had visited our hospital via mobile phone messages and requested their feedback on the services they received. Approximately 5% of all visitors responded and completed a comprehensive questionnaire. The majority of respondents expressed satisfaction with the services provided across various departments. However, they also offered valuable suggestions that helped us identify further areas for improvement and enhance the overall patient experience within our clinic. Drawing upon the feedback received, we meticulously considered the identified issues, redesigned our policies, and implemented strategic changes. Following the implementation of these new approaches, we once again sought patients' feedback on the quality of our services. Patient feedback highlighted the significant impact of optimized service delivery methods, resulting in a substantial increase in patient satisfaction. Overall, this study sheds light on the vital factors that can enhance patients' experience in outpatient clinics, emphasizing the importance of integrating patient feedback into continuous quality improvement initiatives. By utilizing this approach, healthcare providers, administrators, and researchers can effectively improve service quality and patient satisfaction. Consequently, this research paper serves as a valuable reference for public health stakeholders, administrators, and researchers in their pursuit of delivering exceptional healthcare experiences.

In-situ simulation of CPR in the emergency department – A tool for continuous improvement of the initial resuscitation

BackgroundSimulating CPR scenarios in a clinical environment has been described as a method for mitigating latent safety threats. Therefore, we implemented regular inter-professional, multidisciplinary in-situ simulations in the emergency department (ED). AimTo iterate a line-up and action cards for initial CPR management. To examine the experiences among participants regarding attitudes towards simulation and if they perceived any benefits for their patients after the participation. MethodIn 2021 we performed 7 in-situ simulations (15-minute simulation, 15-minute hot debrief) in the ED with the CPR team including doctors and nurses from the ED and anaesthesiology department. A questionnaire was sent to the 48 participants the same day and after 3 and 18 months. Answers were given as yes/no or on a Likert scale 0–5 and are presented as median values with interquartile range (IQR) or frequencies. ResultsA line-up and 9 action cards were created. The response rate of the three questionnaires were 52, 23, and 43%, respectively. In total, 100% would recommend the in-situ simulation to a co-worker. Participants perceived that real patients (5 [3–5]) as well as themselves, (5 [3.5–5]), had benefited from the simulation up to 18 months after. ConclusionThirty-minute in-situ simulations are feasible to implement in the ED and simulation observations were useful for development of standardised role descriptions for resuscitation in the ED. Participants self-report benefit for themselves as well as their patients.

Self-assessment of Public Healthcare Facility in Conformity with Accreditation Guidelines for Quality Services

There is a growing global concern for healthcare quality and patient safety and several countries have initiated accreditation and self assessment programmes for improved quality healthcare and patient safety. Both are based on the quality improvement framework and standards. Case studies have shown that: I) Accreditation certification of hospitals and healthcare facilities has been improved the quality of healthcare and related healthcare services. ii) Self-assessment by healthcare organisations has proved to be very useful tool for continuous and sustainable improvement in organization performance, quality of services, patient satisfaction over and above building the self-confidence of the care providers. In context of facility assessed it was carried out using a checklist specifically designed for this study with 318 items. The scoring pattern comprised total points and percent compliance for functional capacity of the hospital in comparison to prescribed norms. Assessment revealed maximum compliance in the categories of MIS and communication (100%). The facility lacked standard operating procedures, quality assurance system and fire safety system. Self-assessment as continuous feature will lay the basis for planning new interventions for impacting over all quality healthcare outcomes as well sustainability.

Development of a navigation program for patients undergoing hematopoietic stem cell transplantation

To develop a navigation program for patients undergoing hematopoietic stem cell transplantation. Method: The study followed the convergent care research methodology, which provides the researcher's participatory insertion in the field of care practice. The navigation program was divided into four stages: diagnosis, planning, implementation and evaluation. The diagnostic stage consisted of understanding the sector's routine and listing the barriers faced by patients. In the planning phase, the program and its operation were structured. The implementation took place through a pilot study with patients undergoing transplantation. In the evaluation stage, the data were analyzed using the continuous improvement tool (Plan, Do, Check and Correct). Results: The sample consisted of 21 adult patients. The most frequent pathology was acute lymphocytic leukemia, the prevalent sex was male, two patients died during the preparation for the procedure, and only one required readmission after hospital discharge. Conclusion: The development of a navigation program proved to be essential for the adaptation of the patient and family to the new sector and routine, and contributed to greater user satisfaction.

The Influence of IMPACT Approach in Financial Resource Mobilization to Improve Availability of Essential Health Commodities in Sikonge DC

The Tanzanian government, through the Ministry of Health, in collaboration with President’s Office, Regional Administration and Local Government (PORALG) and various stakeholders, has developed several robust electronic health systems such as e-LMIS, GoTHOMIS, FFARS and DHIS2 to streamline health supply chain management processes and improve data visibility. However, the use of this data for informed decision making at all levels of the supply chain was found to be very low, which led to the introduction of IMPACT (Information Mobilized for Performance Analysis and Continuous Transformation) to increase the use of data to improve the supply chain in the country, including Sikonge District Council. Following the implementation of the approach, the IMPACT team in Sikonge discovered low performance in the availability of health commodities among other monitored indicators major reason being inadequate financial resources to procure health commodities. This prompted the team to look for other innovative ways of fundraising to rescue the situation in the council. The objective of this study was therefore to assess the influence of the IMPACT approach methods employed in mobilizing financial resources to improve the availability of health commodities in Sikonge DC. Some of the methods employed by Sikonge team for such a purpose were; conducting a preliminary data-driven analysis and assessment to identify issues related to i-CHF and NHIF services, developing strategies to increase i-CHF enrolment, retention, and disbursements, working on the most common anomalies in the NHIF forms to reduce the number of rejected claims and finally clearing the MSD debt of health facilities to relieve them of the financial burden. These strategies resulted in an increase in i-CHF funds reimbursement from Tsh1.4 million in September 2020 to Tsh8 million in December 2021. NHIF funds reimbursement increased from Tsh696,170 in September 2020 to Tsh12 million in December 2021. The overall percentage of health facilities submitting NHIF claims increased from 17% to 77% over the same period. Thus, the concept of IMPACT and the employed data driven strategies, played a major role in the results achieved in Sikonge and in order to meet the alarming demand for health commodities at service delivery points, council teams should show strong commitment in using real-time data for problem identification and resolution through IMPACT team approach as a tool for continuous improvement.

Diagnostics and Modeling of Enterprise Business Processes as a Mandatory Component of the Operational Efficiency Improvement Project

The article proves that a mandatory component of the successful implementation of an operational efficiency improvement project at an enterprise is the procedure for diagnosing business processes and modeling them. The article proves that companies should transform their business processes based on the concept of Performance Management to improve operational efficiency. It is found that the “lean six sigma” strategy remains a powerful tool for continuous improvement and operational efficiency, especially when combined with other solutions, such as business process modeling, digitalization, advanced analytics and artificial intelligence. The article proves that this will increase labor productivity and efficiency of all business processes, which in turn will increase the company’s competitiveness. To this end, the article proposes to implement projects and programs that will allow building models of existing business processes, reviewing them, identifying shortcomings, and building new models that take into account the current state, changes in the environment, and the company’s strategic orientation and ensure operational flexibility, reliability, and cost-effectiveness. The article proposes the use of modeling tools to help increase business performance and staff productivity, optimize company costs, improve reliability, and ensure lean production conditions.The article proposes a procedure for modeling business processes to identify shortcomings in their functioning and their revision and transformation, reviewing the distribution of responsibilities and relevant documentation at each stage of business processes. The article presents the procedure for modeling business processes using specific examples and builds visual models of business processes functioning on the «Draw.io» platform. The necessity of conducting explanatory work among employees for each participant in the process to understand their role (responsibilities) is substantiated. It is determined that conducting explanatory work among the staff ensures increased responsibility, coherence of actions aimed at adding value to the result.

Lean менеджмент в умовах економічного зростання та розвитку

Economic growth planning plays an important role because it ensures the efficient operation of the company, and efficient operations cannot be carried out without reducing production costs. That is why it is expedient to implement a system of planning of lean management for the purpose of economic growth in the context of the introduction of new types of foreign economic activity. Therefore, the purpose of the work is to develop measures for planning economic growth at the enterprise in the context of introduction of new types of foreign economic activity. The main research methods are data collection, evaluation, analysis, comparison, calculation. In the process of the research, several partial tasks were performed: 1) analyzing the lean management system; 2) to describe the process and methods of implementing the lean concept; 3) to formulate specific recommendations regarding the application of lean management by the enterprise in the context of the introduction of new types of foreign economic activity. The goal of managers in the process of implementing a lean management system is to create a process of continuous elimination of losses, the elimination of any actions that use resources but do not create value for the end user. Constant reduction of losses is the main task of lean management. This concept is an effective tool and mechanism for cost control and continuous improvement of business processes. The basis of the concept of lean management is to generate product value for the end consumer at each stage of its creation. To analyze the emergence of value as a result of work, a map of the flow of value creation, which graphically describes the main processes of the company. Those processes that do not add value to the client should be excluded, because they waste the company's resources. One of the key factors in the success of the lean is the involvement of the maximum number of employees in the work to improve processes, because each employee in his workplace performs certain processes and he/she sees first of all what can be improved in the work process. In order to successfully implement a lean project, the following steps must be performed: – step 1 – creation of the statute; – step 2 – the value creation flow card and the scheme of ideas. The cost of implementing the lean management system itself is small compared to the results. The lean project does not require large investments in production. It is only necessary to take into account that the main benefit from the introduction of lean management is in the long run. The process of transitioning a company to the practice of lean can take an indefinite period of time. It all depends on the leadership, team, corporate culture. But remember, lean manufacturing is an endless process of improvement. It is impossible to complete the construction of a system of continuous improvement.

LINC TOOL: USING QUALITY DATA, COACHING, AND AN IMPROVEMENT CYCLE FOR LEARNING AND IMPROVEMENT IN LONG-TERM CARE

Abstract Providing high quality of care can be challenging for nursing staff because of the continuous changes in healthcare. Nursing staff needs to learn continuously to remain employable and deal with these challenges. Therefore, availability of a continuous learning and improvement tool (LINC tool) using nursing quality data and an improvement cycle to maintain high quality of care in long-term care is important. The development of this tool took place in co-creation with researchers, experts, educational staff and nursing staff working in long-term care. Taskforces with researchers and experts on quality data and education were established to develop the main steps of the tool. Nursing staff was involved in the development and testing of the tool. The LINC tool consists of 1) Assessment of the current learning climate and preferred quality data for nursing staff to work with, 2) Discussing findings from step 1 with the nursing staff team and formulate learning topics, 3) Start improvement cycle (PDCA cycle) using one learning climate topic and one quality data topic as a case to improve quality of care and improve the learning climate. During this cycle, nurse coaches are available to help nursing staff use the LINC tool materials. The LINC tool can be used to improve long-term care and has proven to be feasible. However, the LINC tool is currently tested in more nursing staff teams to increase its usability and effectiveness. Further development of the LINC tool is therefore a constant cycle of developing, implementing, testing, and evaluating, all in cooperation with stakeholders.

The Implementation of Lean Six Sigma (LSS) to reduce Coupler movement time in Wagon Workshop

The industrial and service industries are both affected by today's quickly shifting economic environment. As a result of globalization, manufacturing and service industries are now susceptible to worldwide competition. These businesses face a number of challenges, including shrinking profit margins, customer demand for high-quality products with short lead times, and product variety. Every industrial company today is under enormous pressure to reduce lead times. The benefits of lean six sigma are being used to enhance productivity, quality, and cycle time in manufacturing and service industries all around the world. The use of the Lean six sigma principles and the usage of the DMAIC tool lower the cycle time of coupler movement time in this research. The various time durations involved in movement are recorded and evaluated on Mintab17 software for root cause determination and solution. By using LSS, the movement time, which was 120 minutes in July 2020, was reduced to 80 minutes in just three months. Because LSS implementation is a tool for continual improvement, there is a lot of growth in the future.

Applying value stream mapping for design and optimization of a chocolate bar production line

Objectives. The objective of this paper is to present the contribution of Value Stream Mapping (VSM) to design and optimization of a chocolate production line. Methodology. Initially data was collected for VSM parameters, within a four-month period for the design of the Current State Map. Future State Map was developed by equalizing production volumes to the line product’s Takt Time. A model implementation was carried out and efficacy was evaluated. Contribution. VSM allowed the company to increase uptime of the cooling process by 31.7% and 85g bar overproduction reduction by almost 100%. The company has found this tool highly useful for diagnostic analysis of production. However, the implementation of continuous improvement tools and infrastructure betterment will be needed to achieve higher efficiency.

Assessment of the Key Performance Indicator Proposed by NABH in the Blood Centre of a Tertiary Health Care Hospital in Southern India.

Quality indicators are tools for continuous improvement to enable the blood center to achieve its standards of the highest quality. Hence, they have to be established and monitored regularly for which NABH (National Accreditation Board for Hospitals) accreditation should be sought for. This study was undertaken to assess the Key Performance Indicators (KPI) through clinical audit quality control study of ten parameters, with a goal to improve and meet the benchmark as defined by NABH. All 10 Key Performance Indicators defined by NABH were analysed prospectively in a tertiary care blood centre of southern India. Parameters were compared to that of bench mark standards. Root cause analysis of all non-conformance parameters were done. Problem were identified and action taken to achieve KPI benchmarks in all deviations. Out of the ten KPI's which were studied, more than 50% meet the quality standards. The ones that did not meet the bench mark were TTI-HIV% which was 0.44%, TTI-Syphilis (RPR)% 0.26%, Number of units received back for discarding 5.96%, PRBC wastage% (on-shelf) was 2.11%, FFP, Cryoprecipitate wastage % (on-shelf) was 2.71%, the mean TAT for crossmatch of emergency PRBC blood was 18.3min, 41.11% of FFP QC failure failed, Delay in transfusion time beyond 30min after issue was 19.14%, Donor Deferral rate was 16.36% and TTI Outliers% No. of deviations beyond ± 2SD for HBsAg, HCV, HIV were 14.43%, 12.59% and17.73% respectively. Present study has helped to understand the flaws and problems faced by a tertiary care blood center in sustaining quality. It also actively captured and analysed multiple cross sections of non-conformances.

Pathways to improve health information systems in Ethiopia: current maturity status and implications

BackgroundTo achieve national and international strategic goals, countries are advised to assess the maturity status of their health information systems (HIS), including business continuity and interoperability. This work aims to determine the existing maturity status of the Ethiopian HIS, set HIS improvement goals, and inform a path towards an improved national HIS by the end of 2024.MethodsThis assessment was a collaborative and transparent process that was carried out with the engagement of all key stakeholders through consultation. We used the Stages of Continuous Improvement (SOCI) tool to guide the assessment to measure the maturity level of the Ethiopian HIS in five core domains, 13 components and 39 subcomponents and to guide future plans.ResultsThe overall average score of the national HIS maturity was 2.68/5, which is categorized between repeatable (stage 2) and defined (stage 3) maturity levels. The assessment findings revealed that three out of the five HIS maturity domains were at a repeatable stage. Only the leadership and governance and the data quality and use domains were at the defined maturity level. A majority (7/13) of the subcomponents were at the repeatable level of maturity, while four were at the defined level. Policy, legal and regulatory framework and compliance from the leadership and governance domain and interoperability from the data quality and use domain were categorized as having an emerging status. Considering the current HIS maturity status, gaps and strengths identified, ongoing HIS initiatives, existing platforms, and the interest and level of engagement of senior government leadership, this assessment put forward an improvement roadmap for achieving the desired managed stage (4.37) of maturity by the end of 2024.ConclusionsThe findings show that the overall maturity level of the Ethiopian HIS is 2.68, which is between the repeatable and defined maturity stages. Enforcement of policies and legislation, data exchange among systems, and information and communication technology infrastructure business continuity planning are the main challenges of Ethiopian HIS requiring further investment. Strengthened and collaborative effort is critical to reaching the desired goal of “managed” HIS (stage 4) in the country by 2024.

Increasing colorectal screenings with navigation at federally qualified health centers.

e18566 Background: From 2017 to 2019 there were a total of 423 federally qualified health center colonoscopy referrals (FQHC's) and only 81 (19%) patients followed through and had colonoscopies completed, identifying a significant gap in cancer care within an at risk populations. Methods: The Community Outreach team used a team based problem solving tools and data analytics to increase the number of patients who received colon screenings from FQHC’s. The team held brief, weekly huddles using a variety of continuous improvement tools to identify possible causes of the problem. The team identified 14 potential causes of the 19% gap in FQHC referrals to colonoscopy screenings. The potential causes were analyzed and 4 were identified as the root cause and grouped by common themes into the following opportunities for improvement: Poor engagement with FQHC's. Lack of knowledge on FQHC healthcare effectiveness data and information sets. No standardized workflow for FQHC referrals within the navigation process. Inefficient process for filling the number of screening appointment slots. After identifying the key potential causes, the team developed a task list with countermeasures for improvement and met weekly until the tasks were completed. Through root cause analysis the following key countermeasures were identified: Countermeasure 1: Increased engagement through weekly calls and monthly in person meetings at FQHC's. Countermeasure 2: Developed a quarterly newsletter for FQHC's to review colonoscopy referrals and completed screenings. Countermeasure 3: Developed and implemented a standardized process flow for receiving referrals from FQHC's. Countermeasure 4: Worked with the analytics team to create a dashboard to analyze the real time referrals and completed screenings along with sending e-mail notifications to the navigation program manager providing daily visual management of the number of new patient referrals from FQHC's. Results: After implementing the countermeasures, the community outreach team improved the number of FQHC referrals, from 423 in January of 2017 thru January 2019 to 1399 from January 2020 of December 2021.This was a 160% improvement. They also increased the number of completed colonoscopies from FQHC's from 81 in January of 2017 thru January of 2019 to 328 in January of 2020 thru December of 2021. This was a 200% improvement. The completed screening rate is 23% up from 18%. Conclusions: This project demonstrates the value of utilizing problem solving, visual management and data analytics for continuous quality improvement projects related to patient care. Cross-disciplinary collaboration should be explored with the use of visual tools and other resources to facilitate communication that is understood by all disciplines. The use of patient navigation to schedule patient screening appointments, reminders calls and resolved barriers improved no show rates.

Application of Continuous Improvement Tools to Welding Processes: Case of ENGTP

- Continuous improvement is one of the principles of quality management in business. It is a strong and essential act of management that aims to optimize the overall performance of the company to bring about lasting and permanent positive change. Thus, and to be responsive, a company that encounters a dysfunction must efficiently find a solution. Any company engaged in a process of continuous improvement must use improvement and communication tools among these tools we can cite the Ishikawa diagram, it is an excellent communication tool the latter facilitates obtaining an inventory of real causes that explain a situation that is often hidden behind more apparent causes. Various defects can occur during the processes, although post-processing techniques are not suitable to mitigate or eliminate them. Understanding the defects and their causes represents the first step in designing process monitoring and control tools, once the defects are reviewed and their main causes are identified, this allows the company to prioritize the efforts to resolve the problems and engage in a process of continuous improvement by implementing an action plan that meets the company’s expectations or even engages in a continuous improvement process. Thus with very simple tools, the company will be able to experience a sustainable dynamic. Thus with very simple tools, the company will be able to experience a sustainable dynamic and quality tools bring a real benefit around business continuity plans, feedback, etc. Keywords- Ishikawa diagram, management, continuous improvement, process, tool

MANAGEMENT TOOLS AND SYSTEMS – USAGE IN LOGISTICS COMPANIES IN THE CZECH REPUBLIC

The paper presents the analysis and comparison of management tools and systems usage in companies in Czech Republic as the part of the research that has been done in 2013 and then in 2021 via structured questionnaires. The aim of the paper is to define which management tools and systems are being used by Czech logistics centers, distribution and transport companies and warehouses, what are differences based on the company size (micro, small and medium, large size companies) and what are similarities and new trends across the research sample. The output of the research presents the total and relative frequency of management tools and systems usage comparing 2013 and 2021 outputs and describe current trend of usage, especially with continuous improvement tools (Kaizen, Lean, 6Sigma) that popularity and positive impact on companies’ metrics and results is unarguable. TOP 10 management tools and systems are almost same in 2013 and 2021. Usage of management tools and systems in 2021 is higher than 2013 and the increase is significant. We can see the progress of KPI which total frequency (TF) was 25 and relative frequency (RF) was 5.80% in 2013 and 2021 results presents TF: 292 and RF 76.40%.

A retrospective analysis of near-miss incidents at a tertiary care teaching hospital in Riyadh, KSA

ObjectiveThis study seeks to establish an error-free reporting system that enhances patient safety and organisational culture. It investigates the prevalence of near-miss incident reporting systems by healthcare professionals in the General Surgery Department. MethodsThis retrospective observational study was conducted at a tertiary care teaching hospital in Riyadh, KSA. A sample of 253 medical records, ranging from January 2018 to December 2020, belonging to secondary patients was obtained using the near-miss Datix reporting and occurrence variance reporting system. The demographic variable data of registered patients were based on their age group (18–80 years), length of stay, date of admission, medication prescribed for more than four days, and whether they underwent surgical interventions. The cases were documented after the occurrence of a near-miss incident using a convenience sampling technique. ResultsIn terms of prevalence in the near-miss main categories, medical errors were 248 (98.2%), workplace violations were two (0.80%), and others was one (0.40%). The number of incidence in the subcategories were: prescribing, 227 (89.7%); dispensing, 16 (6.30%) wrong dose/strength, 118 (46.6%), male, 123 (48.6%), and female, 130 (51.4%). The mean age and S.D. of patients was 1.94 ± 0.88 years and the demographic nationality as 1.16 ± 0.37. The one-sample t-test value for the main categories was −235 (p-value < 0.001). ConclusionNear-misses are recognised as essential targets for continuous quality improvement tools to mitigate preoperative incidents in hospitals. These findings can benefit the advancement of techniques for improving guidelines related to compliance and effective communication to improve the preoperative safety of patients.

Breeding Schemes: What Are They, How to Formalize Them, and How to Improve Them?

Formalized breeding schemes are a key component of breeding program design and a gateway to conducting plant breeding as a quantitative process. Unfortunately, breeding schemes are rarely defined, expressed in a quantifiable format, or stored in a database. Furthermore, the continuous review and improvement of breeding schemes is not routinely conducted in many breeding programs. Given the rapid development of novel breeding methodologies, it is important to adopt a philosophy of continuous improvement regarding breeding scheme design. Here, we discuss terms and definitions that are relevant to formalizing breeding pipelines, market segments and breeding schemes, and we present a software tool, Breeding Pipeline Manager, that can be used to formalize and continuously improve breeding schemes. In addition, we detail the use of continuous improvement methods and tools such as genetic simulation through a case study in the International Institute of Tropical Agriculture (IITA) Cassava east-Africa pipeline. We successfully deploy these tools and methods to optimize the program size as well as allocation of resources to the number of parents used, number of crosses made, and number of progeny produced. We propose a structured approach to improve breeding schemes which will help to sustain the rates of response to selection and help to deliver better products to farmers and consumers.

Developing Taiichi Ohno’s Mental Model for Waste Identification in Nontraditional Applications

AbstractThe growth of technology in the manufacturing domain is compelling industry to digitally transform with little to no guidance on what constitutes value-added and nonvalue-added data and information. However, the Toyota production system (TPS) approach, which has proven successful for decades in identifying wastes in physical manufacturing processes, can provide some insights. Extensive research has been conducted on the history of Toyota and the concepts and tools of the TPS, but there is no documentation of how Taiichi Ohno approached problems and developed the classification of wastes (the 7 Wastes) which led to the concepts and tools for continuous improvement that are collectively called the TPS. This article deconstructs literature on Ohno and the Toyota story to reconstruct the mental model that Ohno used to identify and categorize physical production waste in Toyota’s manufacturing operations. The mental model attributed to Ohno proposed in this work is then generalized into a framework for identifying and eliminating both physical and nonphysical wastes in systems. Manufacturing companies and researchers can utilize the framework to foster the same thinking that Ohno used to identify nonvalue-added activities in production processes. Applying the described framework to data and information flows will allow for the discovery of wastes that were once hidden and will lead to the development of tools for improving the data and information needed to support manufacturing in a Smart Manufacturing environment.

The quality continuum: perceptions of institutional accreditation

PurposeAcademics and administrators frequently lament the bureaucracy in higher education, which diverts attention from teaching and research. Heightened monitoring of institutions as a result of dominant neoliberal ideologies shapes perceptions of accreditation as a bureaucratic burden rather than a value-added tool for continuous quality improvement. This paper aims to identify factors that positively and negatively impact a culture of quality in North American accredited postsecondary institutions to address issues of equity and inform policy changes that are relevant to community needs.Design/methodology/approachAcademics’ and administrators’ perceptions of accreditation processes are explored through an interpretivist mixed-methods study that combined focus group and survey results from over 200 participants representative of four-year private and four- and two-year public institutions and tribal colleges in North America.FindingsFindings suggest that a utilitarian and exclusionary mindset perpetuated by neoliberal logics restricts participatory decision-making processes in postsecondary institutions. Furthermore, the research identified a noticeable gap between those who are invited to participate in accreditation processes and those who contribute to decision-making. This lack of inclusive governance inhibits the ability of institutions to respond appropriately to the needs of its community.Originality/valueThe scope of the study and prioritization of qualitative data offers a comprehensive picture of academics’ and administrators’ perceptions and positions them as the experts in their own learning and development. Through participant narratives, strategies for increasing the value of quality assurance processes are illuminated. As a result, the study participants become the change agents who provide the solutions for ameliorating academics’ and administrators’ resistance to quality assurance.